Form 1099-PATR by theyne

VIEWS: 1 PAGES: 6

More Info
									                                        Attention:
This form is provided for informational purposes only. Copy A appears in red, similar to the
official IRS form. Do not file copy A downloaded from this website. The official printed
version of this IRS form is scannable, but the online version of it, printed from this website,
is not. A penalty may be imposed for filing forms that can’t be scanned. See part O in the
current General Instructions for Certain Information Returns for more information about
penalties.
To order official IRS forms, call 1-800-TAX-FORM (1-800-829-3676) or Order Information
Returns and Employer Returns Online, and we’ll mail you the scannable forms and other
products.
See IRS Publications 1141, 1167, 1179 and other IRS resources for information about
printing these tax forms.
                    9797                       VOID                CORRECTED
PAYER'S name, street address, city or town, province or state, country, ZIP    1 Patronage dividends              OMB No. 1545-0118
or foreign postal code, and telephone no.
                                                                              $                                                                          Taxable

                                                                              $
                                                                               2 Nonpatronage distributions
                                                                                                                      2013                          Distributions
                                                                                                                                                  Received From
                                                                               3 Per-unit retain allocations                                       Cooperatives
                                                                              $                                   Form   1099-PATR
PAYER’S federal identification number RECIPIENT’S identification number        4 Federal income tax withheld                                                    Copy A
                                                                              $                                                                                  For
RECIPIENT’S name                                                               5 Redemption of nonqualified        6 Domestic production            Internal Revenue
                                                                                 notices and retain allocations      activities deduction             Service Center
                                                                              $                                   $                                File with Form 1096.
Street address (including apt. no.)                                                                                7 Investment credit                   For Privacy Act
                                                                                                                                                         and Paperwork
                                                                                                                  $                                       Reduction Act
City or town, province or state, country, and ZIP or foreign postal code       8 Work opportunity credit           9 Patron’s AMT adjustment             Notice, see the
                                                                              $                                   $                                        2013 General
                                                                                                                                                        Instructions for
Account number (see instructions)                                2nd TIN not. 10 Other credits and deductions
                                                                                                                                                   Certain Information
                                                                              $                                                                                Returns.
Form 1099-PATR                         Cat. No. 14435F                         www.irs.gov/form1099patr               Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
                                                                   CORRECTED (if checked)
PAYER'S name, street address, city or town, province or state, country, ZIP    1 Patronage dividends              OMB No. 1545-0118
or foreign postal code, and telephone no.                                     $                                                                          Taxable

                                                                              $
                                                                               2 Nonpatronage distributions
                                                                                                                      2013                          Distributions
                                                                                                                                                  Received From
                                                                               3 Per-unit retain allocations                                       Cooperatives
                                                                              $                                   Form   1099-PATR
PAYER’S federal identification number RECIPIENT’S identification number        4 Federal income tax withheld                                                     Copy B
                                                                              $                                                                          For Recipient
RECIPIENT’S name                                                               5 Redemption of nonqualified        6 Domestic production                This is important tax
                                                                                 notices and retain allocations      activities deduction                 information and is
                                                                                                                                                      being furnished to the
                                                                              $                                   $                                         Internal Revenue
                                                                                                                                                          Service. If you are
Street address (including apt. no.)                                                                                7 Investment credit              required to file a return,
                                                                                                                  $                                 a negligence penalty or
                                                                                                                                                     other sanction may be
City or town, province or state, country, and ZIP or foreign postal code       8 Work opportunity credit           9 Patron’s AMT adjustment          imposed on you if this
                                                                              $                                   $                                   income is taxable and
                                                                                                                                                    the IRS determines that
Account number (see instructions)                                             10 Other credits and deductions                                                 it has not been
                                                                              $                                                                                     reported.

Form 1099-PATR                        (keep for your records)                  www.irs.gov/form1099patr               Department of the Treasury - Internal Revenue Service
Instructions for Recipient                                                                 were not taxable when issued to you, you must report the redemption as
                                                                                           ordinary income to the extent of the stated dollar value.
Distributions you received from a cooperative may be includible in your income.            Box 6. Shows the deduction amount you may take based on your portion of
Generally, if you are an individual, report any amounts shown in boxes 1, 2, 3,            patronage dividends or per-unit retain allocations (boxes 1 and 3) attributable to
and 5 as income, unless nontaxable, on Schedule F (Form 1040), Schedule C                  qualified production activities income. To claim the deduction amount, this
(Form 1040), or Form 4835. See the Instructions for Schedule F (Form 1040) and             amount must have been designated in a written notice sent to you from the
Pub. 225 for more information.                                                             cooperative within the payment period under section 1382(d). Enter on the
Recipient's identification number. For your protection, this form may show                 appropriate line of Form 8903.
only the last four digits of your social security number (SSN), individual taxpayer        Box 7. This box shows unused investment credits passed through to you by the
identification number (ITIN), or adoption taxpayer identification number (ATIN).           cooperative. Use Form 3468, and its instructions, to figure the amount of credit
However, the issuer has reported your complete identification number to the IRS            to which you are entitled.
and, where applicable, to state and/or local governments.                                  Box 8. This box shows unused work opportunity credits passed through to you
Account number. May show an account or other unique number the payer                       by the cooperative.
assigned to distinguish your account.
                                                                                           Note. The credit is scheduled to expire on December 31, 2013. Use Form 5884
Box 1. Shows patronage dividends paid to you during the year in cash, qualified            to figure the amount of credit to which you are entitled. If your only source of the
written notices of allocation (at stated dollar value), or other property (not including   credit is the cooperative, use Form 3800, General Business Credits, instead.
nonqualified allocations). Any dividends paid on (1) property bought for personal
use or (2) capital assets or depreciable property used in your business are not            Box 9. Shows the alternative minimum tax (AMT) adjustment passed through to
taxable. However, if (2) applies, reduce the basis of the assets by this amount.           you by the cooperative. Report this amount on Form 6251 on the appropriate
Box 2. Shows nonpatronage distributions paid to you during the year in cash,               line in Part I.
qualified written notices of allocation, or other property (not including                  Box 10. This box shows other unused credits and deductions (including
nonqualified written notices of allocation).                                               depreciation) passed through to you by the cooperative. For information on how
Box 3. Shows per-unit retain allocations paid to you during the year in cash,              to report these, see the instructions for the specific credit form (second
qualified per-unit retain certificates, or other property.                                 generation biofuel producer credit (Form 6478); renewable electricity, refined
                                                                                           coal, and Indian coal production credit (Form 8835, Part II); and agricultural
Box 4. Shows backup withholding. Generally, a payer must backup withhold if                chemicals security credit (Form 8931)), the instructions for Schedules C and F
you did not furnish your taxpayer identification number to the payer. See Form             (Form 1040) and Pub. 946.
W-9 for information on backup withholding. Include this amount on your income
tax return as tax withheld.                                                                Future developments. For the latest information about developments related to
                                                                                           Form 1099-PATR and its instructions, such as legislation enacted after they were
Box 5. Shows amounts you received when you redeemed nonqualified written                   published, go to www.irs.gov/form1099patr.
notices of allocation and nonqualified per-unit retain allocations. Because these
                                               VOID                CORRECTED
PAYER'S name, street address, city or town, province or state, country, ZIP    1 Patronage dividends              OMB No. 1545-0118
or foreign postal code, and telephone no.                                     $                                                                          Taxable

                                                                              $
                                                                               2 Nonpatronage distributions
                                                                                                                      2013                          Distributions
                                                                                                                                                  Received From
                                                                               3 Per-unit retain allocations                                       Cooperatives
                                                                              $                                   Form   1099-PATR
PAYER’S federal identification number RECIPIENT’S identification number        4 Federal income tax withheld
                                                                                                                                                                Copy C
                                                                              $
RECIPIENT’S name                                                               5 Redemption of nonqualified        6 Domestic production                      For Payer
                                                                                 notices and retain allocations      activities deduction

                                                                              $                                   $                                     For Privacy Act
                                                                                                                                                        and Paperwork
Street address (including apt. no.)                                                                                7 Investment credit
                                                                                                                                                         Reduction Act
                                                                                                                  $                                     Notice, see the
City or town, province or state, country, and ZIP or foreign postal code       8 Work opportunity credit           9 Patron’s AMT adjustment             2013 General
                                                                                                                                                       Instructions for
                                                                              $                                   $                                Certain Information
Account number (see instructions)                                2nd TIN not. 10 Other credits and deductions                                                 Returns.
                                                                              $
Form 1099-PATR                                    www.irs.gov/form1099patr                                            Department of the Treasury - Internal Revenue Service
Instructions for Payer
General and specific form instructions are provided           generates a file according to the specifications in Pub.
separately. You should use the 2013 General Instructions      1220, Specifications for Filing Forms 1097, 1098, 1099,
for Certain Information Returns and the 2013 Instructions     3921, 3922, 5498, 8935, and W-2G Electronically. The IRS
for Form 1099-PATR to complete Form 1099-PATR. A              does not provide a fill-in form option.
chart in the general instructions gives a quick guide to      Foreign recipient. If the recipient is a nonresident alien,
which form must be filed to report a particular payment. To   you may have to withhold federal income tax and file Form
order these instructions and additional forms, go to          1042-S, Foreign Person’s U.S. Source Income Subject to
www.irs.gov/form1099patr or call 1-800-TAX-FORM               Withholding. See the Instructions for Form 1042-S and
(1-800-829-3676).                                             Pub. 515, Withholding of Tax on Nonresident Aliens and
Caution: Because paper forms are scanned during               Foreign Entities.
processing, you cannot file Forms 1096, 1097, 1098, 1099,     Need help? If you have questions about reporting on Form
3921, 3922, or 5498 that you print from the IRS website.      1099-PATR, call the information reporting customer service
Due dates. Furnish Copy B of this form to the recipient by    site toll free at 1-866-455-7438 or 304-263-8700 (not toll
January 31, 2014.                                             free). Persons with a hearing or speech disability with
   File Copy A of this form with the IRS by February 28,      access to TTY/TDD equipment can call 304-579-4827 (not
2014. If you file electronically, the due date is March 31,   toll free). The hours of operation are Monday through
2014. To file electronically, you must have software that     Friday from 8:30 a.m. to 4:30 p.m., Eastern time.

								
To top